急性肠梗阻的手术时机选择

目的:探讨急性肠梗阻临床诊断与手术时机。方法:回顾性分析我院近十年来168例肠梗阻病例,比较保守治疗及不同手术时间手术的结果(包括死亡率、肠坏死率、恢复时间的比较)。结果:168例患者行保守治疗痊愈者35例,余133例中转开腹,24h以内急诊手术者51例,24~72h手术者49例,72h后手术者33例。24h以内急诊手术者肠坏死率低于24h后行手术者,恢复时间快于后者(P<0.05)。所有病例总死亡率为5.35%,死因主要为感染性休克、弥漫性腹膜炎、严重电解质酸碱失衡等。结论:(1)准确判断梗阻肠段血运,合理把握手术时机,是降低死亡率的关键;(2)保守治疗时间不宜过长;(3)注意合理使用抗生素,并纠正酸碱失衡及电解质失衡。

The Timing of Operation in Acute Intestinal Obstruction

Objective:To observe the timing of operation in acute intestinal obstruction.Methods:168 cases of acute intestinal obstruction patients cared in nearly a decade were investigated in our hospital.Compared the result(including mortality,bowel necrosis rate,recovery time)between conservative treatment and operation treatment in different time.Results:35 cases were cured by conservative treatment and the rest underwent operation treatment.51 cases were operated in 24 hours;49 cases were in 24~72 hours,and 33 ca...